,,ii  #aadth ,,congress  #b;d ,session  
,s4 #bgcf  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,march #ag1    
#bjaf ,mr4 ,thune 7for himself1 ,ms4    
,heitkamp1 ,mr4 ,roberts1 ,mr4 ,crapo1  
,mr4 ,rounds1 ,mrs4 ,capito1 ,mr4       
,grassley1 ,mr4 ,manchin1 ,mr4 ,daines1 
,mr4 ,barrasso1 ,mr4 ,cochran1 ,ms4     
,hirono1 ,mr4 ,bennet1 ,mrs4 ,ernst1    
,mr4 ,king1 and ,mr4 ,tester7 introduced
 the following bill2 which was read     
twice and referred to the ,committee on 
,finance  ,a ,,bill  ,to improve access 
to durable medical equipment for        
,medicare beneficiaries under the       
,medicare program1 and for other        
purposes4  #a4 ,short title  ,this ,act 
may be cited as the ,patient ,access to 
,durable ,medical ,equipment ,act of    
#bjaf4  #b4 ,extension of the transition
 to new payment rates for durable       
medical equipment under the ,medicare   
program ,the ,secretary of ,health and  
,human ,services shall extend the       
transition period described in clause   

7i7 of section #dad4baj7;g77#i7 of title
 #db1 ,code of ,federal ,regulations1   
from ,june #cj1 #bjaf1 to ,september    
#cj1 #bjag 7with the full implementation
 described in clause 7ii7 of such       
section applying to items and services  
furnished with dates of service on or   
after ,october #a1 #bjag74  #c4 ,bid    
ceiling for competitive acquisition for 
durable medical equipment under the     
,medicare program ,section #ahdg7;b77#e7
 of the ,social ,security ,act 7#db     
,u4,s4,c4 #aciew-#c7;b77#e77 is         
amended-- 7#a7 in subparagraph 7,a7--   
7,a7 by inserting 1 subject to          
subparagraph 7,e71 after subsection     
7a77#b72 and  7,b7 by inserting 1       
subject to subparagraph 7,e71 after     
,based on such bids2 and  7#b7 by adding
 at the end the following new           
subparagraph3  7,e7 ,bid ceiling for    
durable medical equipment  7i7 ,in      
general ,the ceiling for a bid submitted
 for applicable covered items may not be
 less than the fee schedule amount that 

would otherwise be determined for such  
items under section #ahcd7;a71 section  
#ahcd7;h71 or section #ahdb7s77#a7 on   
,january #a1 #bjae1 updated by the      
covered item update for such items under
 section #ahcd7;a77#ad77,l71 section    
#ahcd7;h71 or section #ahdb7s77#a71     
respectively1 as appropriate for the    
year with respect to which the bid      
ceiling is established for such         
applicable covered item4  7ii7          
,application to new covered items ,the  
,secretary shall establish a process for
 purposes of applying clause 7i7 with   
respect to applicable covered items for 
which no fee schedule amount would      
otherwise be paid under section         
#ahcd7;a71 section #ahcd7;h71 or section
 #ahdb7s71 as appropriate1 on ,january  
#a1 #bjae4  7iii7 ,applicable covered   
items defined ,for purposes of this     
subparagraph1 the term applicable       
covered items means competitively priced
 items and services described in        
subsection 7a77#b7 that are furnished   

with respect to rounds of competition   
that begin on or after ,january #a1     
#bjag4  4  #d4 ,requirements in         
determining adjustments using           
information from competitive bidding    
programs ,section #ahcd7;a77#a77;,g7 of 
the ,social ,security ,act 7#db         
,u4,s4,c4 #aciem7a77#a77;,g77 is amended
 by adding at the end the following new 
sentence3 8,in the case of items and    
services furnished on or after ,january 
#a1 #bjai1 in making any adjustments    
under clause 7ii7 or 7iii7 of           
subparagraph 7,f71 the ,secretary       
shall--  7i7 solicit and take into      
account stakeholder input2 and  7ii7    
take into account the highest amount bid
 by a winning supplier in a competitive 
acquisition area and a comparison of    
each of the following with respect      
non-competitive acquisition areas and   
competitive acquisition areas3  7,i7    
,the average travel distance and cost   
associated with furnishing items and    
services in the area4  7,,ii7 ,any      

barriers to access for items and        
services in the area4  7,,iii7 ,the     
average delivery time in furnishing     
items and services in the area4  7,,iv7 
,the average volume of items and        
services furnished by suppliers in the  
area4  7,v7 ,the number of suppliers in 
the area4  4  #e4 ,monthly report on the
 results of the monitoring of access of 
,medicare beneficiaries to durable      
medical equipment and of health outcomes
 ,not later than the first of each month
 7beginning with ,may #a1 #bjaf1 and    
ending with ,september #a1 #bjag71 the  
,secretary of ,health and ,human        
,services shall publish on the ,internet
 website of the ,centers for ,medicare  
,medicaid ,services the results of the  
monitoring of access of ,medicare       
beneficiaries to durable medical        
equipment and of health outcomes1 as    
described on page #ffbbh in the final   
rule published by the ,center for       
,medicare  ,medicaid ,services on       
,november #f1 #bjad1 and entitled       

,medicare ,program2 ,end-,stage ,renal  
,disease ,prospective ,payment ,system1 
,quality ,incentive ,program1 and       
,durable ,medical ,equipment1           
,prosthetics1 ,orthotics1 and ,supplies 
7#gi ,fed4 ,reg4 #ffabj-ffbfe74  #f4    
,revision of effective date of provision
 limiting ,federal ,medicaid            
reimbursement to ,states for durable    
medical equipment 7,,dme7 to ,medicare  
payment rates  7a7 ,in general ,section 
#aijc7;i77#bg7 of the ,social ,security 
,act 7#db ,u4,s4,c4 #acif;b7i77#bg77 is 
amended by striking ,january #a1 #bjai  
and inserting ,october #a1 #bjah4  7b7  
,effective date ,the amendment made by  
subsection 7a7 shall take effect as if  
included in the enactment of section    
#ejc of division ,o of ,public ,law     
#aad-aac4